METHOD FOR DETERMINING PARAMETERS OF RADIOFREQUENCY ABLATION DURING ENDOSCOPIC TREATMENT OF PATIENTS WITH ADENOMAS OF MAJOR DUODENAL PAPILLA WITH INTRADUCTAL EXTENSION Russian patent published in 2024 - IPC A61B18/20 A61B6/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to endoscopic surgery, and can be used to determine parameters of radiofrequency ablation during endoscopic treatment of patients with adenomas of major duodenal papilla (MDP) with intracurrent spread. Method enables to determine the extent of the spread of the MDP adenoma of the intraductal fibroids and the density type of the adenomatous tissue within the duct according to the Ueno classification before the surgery. Due to sonoelastography the first type of density is determined in case of uniform staining of the focus in green colour – elastographic signs of soft-elastic structure of the centre. Second type of density is determined in the presence of a mosaic structure, which includes both blue and green shades of colour – elastographic signs of heterogeneity of the focus structure with a predominance of a soft-elastic component. If observing the first type of density of the adenomatous tissue inside the duct and the length of the MDP adenoma spreading to the ducts of up to 20 mm, RFA is performed for 90 seconds at energy power of 8 W. If observing the first type of adenomatous tissue density inside the duct and the length of the MDP adenoma spreading to ducts of 20 mm and more, RFA is performed with repositioning of the catheter for complete destruction of tumour tissues throughout length of 140 seconds at power of 8 W. If observing the second type of density of adenomatous tissue inside the duct and the extent of propagation of the MDP adenoma on the ducts of up to 20 mm, RFA is performed for 120 seconds at energy power 9 W. If observing the second type of adenomatous tissue density inside the duct and the length of the MDP adenoma spreading to duct of 20 mm and more, RFA is performed with repositioning of the catheter for complete destruction of tumour tissues throughout length of 140-160 seconds at power of 9 W.

EFFECT: method enables the safe destruction of the intraductal portion of the adenoma and reduces the risk of developing residual adenomatous growths by determining the length of the MDP adenoma spread on the ducts and the density type of the adenomatous tissue.

1 cl, 4 ex